June 12, 2012 | by City of Hope Staff
There’s almost nothing more terrifying as learning your child has been diagnosed with cancer. And there’s almost nothing more joyful as watching your child come out of treatment as a survivor. That rollercoaster of emotions doesn’t end upon leaving the hospital, though.
Chemotherapy and radiation treatments put many childhood cancer survivors at risk for serious heart problems later in life. As these children grow up, move away from home and leave their cancer medical teams, they may not get the kind of monitoring that could detect these heart problems early. But they should, not only for health reasons — but also for financial ones.
City of Hope researchers recently showed that regular heart screening is especially important and cost-effective in one group of survivors in particular: those who were toddlers when they first were diagnosed and were treated with radiation and high doses of chemotherapies called anthracyclines.
The findings back up recommendations from the Children’s Oncology Group (COG), the world’s largest organization devoted exclusively to childhood and adolescent cancer research. COG established expansive guidelines for screening pediatric cancer survivors based on a consensus among the group’s more than 200 member institutions.
F. Lennie Wong, Ph.D., associate professor in the Department of Population Sciences, led a research team from seven different institutions to look into how survivors were doing under those guidelines.
“Congestive heart failure is a concern for many childhood cancer survivors and our efforts at addressing the long-term health issues that survivors may face are making a difference,” said Wong, who presented the study at the annual meeting of the American Society of Clinical Oncology.
Using data from the nation’s largest study of childhood survivors, the U.S. Census and other trusted sources, the scientists looked at the cost-effectiveness of the months and years of life gained due to early detection of heart problems through regular echocardiograms.
They found that screenings were most cost-effective in childhood cancer survivors diagnosed between ages 1 and 4 and who received both radiation therapy and anthracycline doses higher than 300 mg/m2. Those who got lower doses of anthracyclines benefited from heart screening as well.
And all survivors who received anthracycline doses higher than 300 mg/m2, regardless of their age at diagnosis and whether they received radiation, showed cost-effective benefits from screening.
About half of all frontline chemotherapy regimens today contain an anthracycline such as doxorubicin or epirubicin.